A SYSTEMATIC REVIEW OF ENABLERS AND BARRIERS TO CANCER SURVIVORSHIP IN NIGERIA

Abstract Background Nigeria is benefitting from public health and healthcare advancement which is increasing cancer care in the country. As a result, more people are surviving cancer. However, this should not mask the fact that Nigeria, a rapidly aging country which an increased risk of cancer incidence, bears a heavy health burden of about 72,000 cancer deaths per year — this underscores cancer as a leading cause of death among Nigerians. The purpose of this study was to identify and synthesize factors that are enablers or barriers to cancer survivorship in Nigeria and add to the body of knowledge on cancer survivorship in the global south. Method. Using PRISMA guidelines, we conducted a systematic review across Scopus, PubMed, and databases. Given that cancer survivorship covers periods from diagnoses, to treatment, and end of life, we identified 31 peer-reviewed studies that assessed cancer treatment, management, care, and survivorship in Nigeria. Results Eight themes emerged from our review of 31 peer-reviewed studies that examined factors that are enablers of barriers to cancer survivorship among Nigerians. Some of the themes include a desire to survive, the availability of treatment options, self-management, and the availability of pseudo-healthcare providers. We later grouped the themes under three categories, healthcare, economic, and psychological factors. Conclusion Cancer survivors in Nigeria are confronted with several issues that affect their quality of life and health outcomes. This highlights the need for studies on cancer survivorship to inform the design of tailored health improvement interventions for cancer survivors in Nigeria.


A PILOT FAMILY COACHING INTERVENTION FOR PEOPLE WITH TYPE 2 DIABETES AND A FAMILY MEMBER
Kristin August 1 , Kathleen Jackson 1 , and Marsha Rosenthal 2 , 1. Rutgers University,Camden,New Jersey,United States,2. Rutgers University,New Brunswick,New Jersey,United States Type 2 diabetes is a common chronic condition in later life that requires substantial lifestyle changes.Most diabetes management occurs at home with the help -and sometimes hindrance -of family members.Although coaching has become a common strategy in healthcare to supplement diabetes education, few interventions have prepared family members to be coaches, despite the documented benefit of including family members in chronic disease management interventions.The overall goal of our pilot intervention was to develop and test a family coaching approach to enhance patients' diabetes self-management while preserving relationship quality and both individuals' well-being.Participants were recruited from local diabetes education classes and through provider referrals, and included 20 dyads in the intervention group (patient Mage=59.12) and 20 dyads in the control group (patient Mage=57.06).The intervention, involving 5 interactive group sessions (in-person or virtual) led by a facilitator, covered evidence-based material developed by the investigators on diabetes education and coaching strategies.Behavioral, clinical, emotional, and relational metrics were assessed via a survey at baseline, postintervention, and 3 months later; intervention participants also completed a program evaluation survey and participated in a focus group.Survey findings revealed some positive effects for diabetes self-management behaviors, no effects for short-term clinical markers, negative effects for emotional well-being, and both positive and negative effects for relational well-being.Participants reported being satisfied with the program overall; they indicated learning a lot and having a positive experience.A translation and cultural adaptation of this program for Spanish-speaking populations is currently underway.Background.Nigeria is benefitting from public health and healthcare advancement which is increasing cancer care in the country.As a result, more people are surviving cancer.However, this should not mask the fact that Nigeria, a rapidly aging country which an increased risk of cancer incidence, bears a heavy health burden of about 72,000 cancer deaths per year -this underscores cancer as a leading cause of death among Nigerians.The purpose of this study was to identify and synthesize factors that are enablers or barriers to cancer survivorship in Nigeria and add to the body of knowledge on cancer survivorship in the global south.Method.Using PRISMA guidelines, we conducted a systematic review across Scopus, PubMed, and databases.Given that cancer survivorship covers periods from diagnoses, to treatment, and end of life, we identified 31 peer-reviewed studies that assessed cancer treatment, management, care, and survivorship in Nigeria.
Results.Eight themes emerged from our review of 31 peer-reviewed studies that examined factors that are enablers of barriers to cancer survivorship among Nigerians.Some of the themes include a desire to survive, the availability of treatment options, self-management, and the availability of pseudo-healthcare providers.We later grouped the themes under three categories, healthcare, economic, and psychological factors.
Conclusion.Cancer survivors in Nigeria are confronted with several issues that affect their quality of life and health outcomes.This highlights the need for studies on cancer survivorship to inform the design of tailored health improvement interventions for cancer survivors in Nigeria.Type 2 diabetes (T2D) is a major public health concern in older adults.Physical activity (PA) and healthy eating (HE) are two major lifestyle intervention strategies in diabetes self-management for controlling glucose levels, preventing complications, and improving functionality and quality of life.This qualitative study aimed to explore perceived factors influencing PA and HE among predominately Latino older adults with T2D ((age=70.5±4.8;Latinos=73.3%).We conducted semi-structured interviews with 15 community dwelling older adults with T2D at the end of a 12-week pre-and post-study assessing self-monitoring on lifestyles and health outcomes.All interviews were recorded and transcribed.Two researchers analyzed the data independently using a combination of deductive and inductive thematical analysis.Codes were categorized into five themes based on the socio-ecological framework, and sub-themes were identified.The themes included five levels of factors: 1) individual (e.g., knowledge, self-efficacy, self-monitoring, perceived benefits and threats, health status,); 2) interpersonal (e.g., family, friend, health provider); 3) organizational (e.g., availability of physical activity equipment in senior apartments); 4) environment (e.g., culture norms); and 5) policy factors (e.g., health provider, retirement).The factors in one level could influence the factors in another level.Most current lifestyle interventions focus on individual level, and multilevel lifestyle interventions to promote healthy lifestyles, and improve health, independence, and quality of life in older adults with T2D are warranted.The input of additional stakeholders such as family members and community staff need to be accounted when designing multilevel intervention in older adults with T2D.

RECOMMENDATIONS REGARDING THE DESIGN OF PAIN ASSESSMENT AND MANAGEMENT TOOL FOR OLDER ADULTS WITH HEART FAILURE
Youjeong Kang 1 , Yong Kyung Choi 2 , and Seung-Eun Oh 3 , 1. University of Utah, Salt Lake City, Utah, United States, 2. University of Pittsburgh, Pittsburgh, Pennsylvania, United States, 3. Seoul Women's College of Nursing, Seoul,

Republic of Korea
Nearly 80% of all patients with heart failure (HF) are older adults (≥65 years of age) who are at high risk for frequent hospitalizations.Older adults with HF may delay in responses to pain that could trigger the burden of HF symptoms such as dyspnea due to the increased cardiovascular workload and oxygen demands.However, there is a concern that healthcare providers may be poorly prepared to assess and manage pain when reported by specific populations.This qualitative secondary analysis examined the design recommendations of HF providers for a comprehensive home-based pain assessment and management tool for older adults with HF.The study used in-depth interviews with 20 healthcare providers specializing in HF across different states.Participants provided various recommendations, including a checklist of questions about the patient's past experience with pain, their living environment, and any activities that trigger pain.While some participants preferred electronic tools, such as an mHealth app, for data collection and analysis, they acknowledged the limitations of using technology for older adults.The tool should be straightforward, easy to navigate, and involve patients in the design process to ensure their motivation and buy-in.The tool should also consider the caregiver's input.In conclusion, this study highlights the importance of a comprehensive assessment of pain symptoms and daily activities to provide personalized care for older adults with HF.The design recommendations provided by healthcare providers can aid in the development of a unique home-based pain assessment and management tool for older adults with HF.

MULTILEVEL LIFESTYLE INTERVENTIONS ARE NEEDED TO IMPROVE DIABETES SELF- MANAGEMENT IN OLDER ADULTS Yan
Du 1 , Lixin Song 2 , Mitzi Gonzales 1 , Sara Espinoza 3 , Carlos Jaen 1 , Bei Wu 4 , and Erin Finley 1 , 1. UT Health San Antonio, San Antonio, Texas, United States, 2. University of Texas Health Science Center at San Antonio, San Antonio,

LENS TO EVALUATE CANCER SURVIVORSHIP IN BLACKS AND LATINX IN THE US Candidus
Nwakasi 1 , Darlingtina Esiaka 2 , Saamantha Pierre-Louis 3 , and Onyeka Ekwebene 4 , 1. University of Connecticut, Storrs, Connecticut, United States, 2. University of Kentucky, Lexington, Kentucky, United States, 3. Providence College, Providence, Rhode Island, United States, 4. East Tennessee State University, Johnson City, Tennessee, United States Background.A sociocultural lens such as the PEN-3 Cultural Model offers an opportunity to better understand the extreme psychosocial, physical, emotional, and financial challenges of Black and Latinx cancer survivors in the community experience.By focusing on cultural identity,